• Title/Summary/Keyword: 완화의료

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The Influence of Moral Behavior, Biomedical Ethics Consciousness, and Death Attitudes on Hospice Awareness in Nursing Freshman (간호학과 1학년의 도덕적 행동, 생명의료윤리 의식, 죽음 태도가 호스피스 인식에 미치는 영향)

  • Kim, Jeong-Sook;Je, Nam-Joo
    • Journal of Digital Convergence
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    • v.19 no.1
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    • pp.275-284
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    • 2021
  • The purpose of this study was to provide basic data for developing hospice intervention strategies that can enhance hospice care perception plus attitude toward death of nursing students by grasping the factors affecting the perception of first grade students. Data were collected from 185 nursing students at J university in G-do. Analysis was done using t-test, ANOVA, Pearson correlation coefficient, and Multiple regression with IBM SPSS WIN/25.0. Hospice care perception was correlated to moral behavior (r=.22, p=.002) and biomedical ethics consciousness (r=.29, p<.001). The most influential factor on the subjects' hospice care perception was biomedical ethics consciousness (β=.224, p=.012), followed by high financial competence of parents (β=.187, p=.027). The explanatory power was 11.5%. Therefore, systematic programs that can enhance moral behavior and biomedical ethics consciousness are necessary to promote awareness of hospice care. Also, the following data can be utilized as basic data to help develop hospice education programs.

A Study on Radio Wave Resource Management and Industrial Technology Revitalization in The Medical and Energy Fields (의료 및 에너지 분야 전파 자원 관리 및 산업 기술 활성화 방안에 대한 연구)

  • Yoon, Sang-Ok;Seok, Gyeong-Hyu
    • The Journal of the Korea institute of electronic communication sciences
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    • v.17 no.4
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    • pp.543-554
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    • 2022
  • In this study, the government's investment, laws, regulations, and difficulties related to IoT radio technology in the energy and medical fields are mainly analyzed. Also, plans for dissemination, technology preemption, and commercialization are derived to enhance global competitiveness. Research on ways to secure and predict radio wave application technologies in energy and medical fields, and to alleviate barriers to entry for new business operators. Analyzes the efficiency of support measures using expert groups in each energy and medical field, analyzes the utilization value of accumulated data, and proposes mid- to long-term promotion systems and support measures, as well as utilization measures of data held by external agencies related to radio waves.

The Meaning of Good Dying of Chinese Terminally Ill Cancer Patients in Taiwan

  • Chao, Co-Shi Chantal
    • 한국호스피스완화의료학회:학술대회논문집
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    • 2000.12a
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    • pp.162-174
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    • 2000
  • The purpose of this hermeneutic study was to investigate the meaning of "good dying" of Chinese terminally ill cancer patients in Taiwan; the factors related to this morning; and the strategies cancer patients used to ensure "good dying". Indepth unstructured interviews, prolonged participant observations, and review of clinical records were selected as the methods for data collection. In the four and one-half month period of data collection, the researcher was in the role of a full time clinical nurse specialist who directly took care of the subject patients in 4 hospitals and in patients' homes. The 20 subject were selected purposively according to selection criteria and various demographic backgrounds. Interview transcripts and field notes comprised the data for analysis. The results were composed by 3 constitutive patterns and 12 themes. Achieving inner peace appeared to herald the good dying state. The "good dying" for Chinese terminally ill cancer patients in Taiwan meant peace of body, peace of mind, and peace of thought. The constitutive pattern of peace of body included 4 themes: (1)minimizing the agony of physical symptoms; (2)short period of dying process without lingering death; (3) cleanliness, neatness, and integrity of the body; and (4) mobility. The constitutive pattern of peace of mind included 5 themes: (1) yielding; (2) non-attachment; (3) not to be lonely; (4) settle down all affairs; and (5) being in a preferred environment and enjoying nature. The third constitutive pattern of peace of thought included 3 themes: (1) getting through day by day without thinking; (2) meaningful life; and (3) expectation that the suffering would be ending. Through understanding of the terminally ill cancer patient' needs in their meanings of "good dying", recommendations can be made for humanistic care. The findings of this study have recommendations for care givers daily contact with dying patients and for medical and nursing education.

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Experience of Home-Based Hospice Care of Terminal-Cancer Patients (말기암환자에서 가정호스피스완화 돌봄 경험)

  • Kim, Boon Han;Kang, Hwa Jung
    • Journal of Hospice and Palliative Care
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    • v.17 no.4
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    • pp.223-231
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    • 2014
  • Purpose: The purpose of this study was to understand terminal cancer patient's experiences of home-based hospice care. Methods: The data were collected from July 2011 through September 2010. Data were collected from 10 terminal cancer patients who received home-based hospice care services and by using in-depth interview. The data were analyzed using Colaizzi's phenomenological method. Results: Data were classified by 25 themes comprising 14 theme clusters and five categories. The five categories were 'life quality deterioration', 'appreciation', 'acceptance of the rest of their lives', 'Prepared for death with religion', 'negative coping'. Conclusion: Systematic hospice care should be provided to understand life experience of patients with terminal cancer who receive home-based hospice care, to help them overcome negative experiences and grow a positive perspective.

The use of digital health care for the relief of depression in the elderly: A systematic review and meta-analysis (노인의 우울 완화를 위한 디지털 헬스케어의 활용: 체계적 문헌고찰 및 메타분석)

  • Seo, Eunju;Park, Myung-Bae;Im, Jinseop
    • Journal of Industrial Convergence
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    • v.20 no.9
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    • pp.71-79
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    • 2022
  • This study comprised a systematic review and meta-analysis to determine how digital health care to relieve depression of the elderly. The CINAHL, Embase, Medline, DBpia, KERIS, KISS and RISS were used. As a result of the systematic search, a total of 4,071 studies were assessed and six studies were ultimately selected based on the inclusion and exclusion criteria. Of these, a total of five studies were available for meta-analysis; the effect size was calculated. The effect size of digital health care was statistically significant in reducing depression(SMD=-4.73, 95% CI -7.44 to -2.01, Z=3.41, p=.0007). Since only web-based programs are included in the analysis among types of digital health care, we suggest that we consider ways to reduce depression in the elderly by applying various digital health care in the future.

Effects of the Combination of Oxygen and Color Light on Stress Relaxation: Psychological and Autonomic Responses (산소와 색채 조명 자극의 조합이 스트레스 완화에 미치는 효과: 심리 및 자율신경계 반응을 중심으로)

  • Jang, Eun-Hye;Kim, Ah-Young;Jang, Yongwon;Kim, Bo-Seong;Choi, Yong-Bok;Kim, Seung-Chul;Lee, Sang-Kone;Kim, Seunghwan
    • Science of Emotion and Sensibility
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    • v.22 no.1
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    • pp.55-64
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    • 2019
  • Stress is accompanied by changes in the responses of the autonomic nervous system, and the heart rate variability (HRV) index is a quantitative marker that reflects autonomic responses induced by stressors. In this study, we observed changes in the autonomic responses induced by combinations of 30% oxygen administration and color light for stress relaxation. In all, 42 participants produced stress symptoms over the preceding two weeks, as rated on the stress response scale. After stress assessment, they were exposed to three therapeutic conditions, and electrocardiogram (ECG) signals were recorded before, during, and after therapy. The three therapy conditions consisted of only 30% oxygen administration with white light, a combination of 30% oxygen and orange light, and a combination of 30% oxygen and blue light. The HRV indices extracted from ECG signals were heart rate (HR), the standard deviation of the RR interval (SDNN), the mean square root of consecutive RR interval difference values (RMSSD), the low frequency component of HRV (LF), the high frequency component (HF), and the LF/HF ratio. These indicators were used to compare mean values before and after therapy. The results showed that HR and the LF/HF ratio were significantly lower after therapy than before it. In particular, the condition with 30% oxygen and blue light yielded significantly greater RMSSD and HF increases, as well as decreases in LF/HF ratio than in other two conditions. Our results suggest that therapy with 30% oxygen and blue light is the most effective for the relaxation of stress, which implies autonomic balance by parasympathetic activation.

A Study of Social Workers' Understanding of Elderly Patients' and Family Caregivers' Rights to End-of-Life Care Decisions and of Their Own Roles in the Process (노인환자와 가족의 임종의료결정 권리 및 사회복지사 역할 이해도 - 장기요양 입소 시설 사회복지사를 대상으로 -)

  • Han, Sooyoun
    • Journal of Hospice and Palliative Care
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    • v.18 no.1
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    • pp.42-50
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    • 2015
  • Purpose: This study was aimed to analyze how social workers understand the rights for elderly patient and family caregiver to make end-of-life (EOL) care decisions and their roles the decision making process. Methods: The study employed a quantitative research method of collecting data from a structured questionnaire that was filled out by 334 social workers at long-term care facilities. Data were analyzed by descriptive statistics, mean differences, correlation between variables, using SPSS 20.0 program. Results: The mean score for the understanding the rights to an EOL care decision was $3.46{\pm}0.69$ and of their own roles $3.48{\pm}0.84$. The level of understanding significantly differed by social workers' experience of assisting a process to make an EOL care decision such as advance directives and life sustaining treatment, work experience, and the number of beds. Positive correlation was observed between the level of understanding of the rights for EOL care decisions and of social workers' roles (Pearson r=0.329, P<0.001). Conclusion: This study proposes development of an education program for social workers and devising standards for the EOL care decision making process to protect elderly patients, family caregivers as well as social workers in a long term care facility.

Regarding Issues on the Lawsuit of Medical Malpractice in the Implant Procedure -Focusing on the contract's legal character and the mitigation of burden of proof- (임플란트 시술상 의료과오의 소송상 쟁점에 관하여 -계약의 법적성격 및 입증책임 완화를 중심으로-)

  • Han, Taeil
    • The Korean Society of Law and Medicine
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    • v.19 no.1
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    • pp.143-163
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    • 2018
  • Implant procedure belongs to so called a commercialized medical treatment, its procedure is simple and clear, and the possibility of success is almost 100%. In addition, it is a selective method rather than an inevitable method for a patient's health, so the importance of liability for explanation is especially emphasized for protection of autonomous decisions by patients. Considering these characteristics, the plaintiff in the relevant case said that the contract of implant procedure has the characteristic of subcontract, and only the failure of implant itself and the violation of liability for explanation should be the defendant's fault liability. In addition, although the above procedure contract is considered as delegation rather than subcontract, whether it's the defendant's malpractice should be judged by general people's common sense rather than average people in the industry. Therefore, if all the implanted teeth were removed due to bleeding and pains, and the patient suffered from dysaesthesia during the process, the defendant's malpractice is fully proved. When the judgements of implant medical malpractice were researched, the court doesn't consider implant contract as subcontract, but it judges dentist's malpractice by whether the implant itself is successful, so it seems that the court acknowledges similar characteristics with subcontract whose purpose is completion of work to some degree. In addition, considering the detailed contents of presented medical malpractices, it seems that judging medical malpractice is based on the common sense of general people. Therefore, the argument of the plaintiff is valid when the fact the adjustment amount is relevant to the amount that the plaintiff initially claimed is considered even though the relevant case was decided to be compulsory mediation.

Latest Supreme Court Decision on Proof of Causation in Medical Malpractice Cases - Focusing on Supreme Court decision 2022da219427 on August 31, 2023 and the Supreme Court decision 2021Do1833 on August 31, 2023 - (의료과오 사건에서 인과관계 증명에 관한 최신 대법원 판결 - 대법원 2023. 8. 31. 선고 2022다219427 판결 및 대법원 2023. 8. 31. 선고 2021도1833 판결을 중심으로 -)

  • HYEONHO MOON
    • The Korean Society of Law and Medicine
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    • v.24 no.4
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    • pp.3-36
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    • 2023
  • The main issue in medical malpractice civil litigation is medical negligence and the causal relationship between medical negligence and damages. Regarding the presumption of causality in cases where medical negligence is proven, there is a previous Supreme Court decision 93da52402 on February 10, 1995, but it is difficult to find a case that satisfies the textual requirements of the above decision, and yet, in practice, the above decision is cited. In many cases, causal relationships were assumed, and criticism was consistently raised that it was inconsistent with the text of the above judgment. In its ruling, the Supreme Court reorganized and presented a new legal principle regarding the presumption of causality when medical negligence is proven in a civil lawsuit. According to this, If the patient proves ① the existence of an act that is assessed as a medical negligence, that is, a violation of the duty of care required of an ordinary medical professional at the level of medical care practiced in the field of clinical medicine at the time of medical practice, and ② that the negligence is likely to cause damages to the patient, the burden of proving the causal relationship is alleviated by presuming a causal relationship between medical negligence and damage. Here, the probability of occurrence of damage does not need to be proven beyond doubt from a natural scientific or medical perspective, but if recognizing the causal relationship between the negligence and the damage does not comply with medical principles or if there is a vague possibility that the negligence will cause damage, causality cannot be considered proven. Meanwhile, even if a causal relationship between medical negligence and damage is presumed, the party that performed the medical treatment can overturn the presumption by proving that the patient's damage was not caused by medical negligence. Meanwhile, unlike civil cases, the standard is 'proof beyond reasonable doubt' in criminal cases, and the legal principle of presuming causality does not apply. Accordingly, in a criminal case of professional negligence manslaughter that was decided on the same day regarding the same medical accident, the case was overturned and remanded for not guilty due to lack of proof of a causal relationship between medical negligence and death. The above criminal ruling is a ruling that states that even if 'professional negligence' is recognized in a criminal case related to medical malpractice, the person should not be judged guilty if there is a lack of clear proof of 'causal relationship'.

Safety and Efficacy of Peripherally Inserted Central Catheters in Terminally Ill Cancer Patients: Single Institute Experience

  • Park, Kwonoh;Lim, Hyoung Gun;Hong, Ji Yeon;Song, Hunho
    • Journal of Hospice and Palliative Care
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    • v.17 no.3
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    • pp.179-184
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    • 2014
  • Purpose: We investigated the safety and efficacy of peripherally inserted central catheters (PICCs) in terminally ill cancer patients. Methods: A retrospective review was conducted on patients who underwent PICC at the hospice-palliative division of KEPCO (Korea Electric Power Corporation) Medical Center between January 2013 and December 2013. All PICCs were inserted by an interventional radiologist. Results: A total of 30 terminally ill cancer patients received the PICC procedure during the study period. Including one patient who had had two PICC insertions during the period, we analyzed a total of 31 episodes of catheterization and 571 PICC days. The median catheter life span was 14.0 days (range, 1~90 days). In 25 cases, catheters were maintained until the intended time (discharge, transfer, or death), while they were removed prematurely in six other cases (19%; 10.5/1000 PICC days). Thus, the catheter maintenance success rate was 81%. Of those six premature PICC removal cases, self-removal due to delirium occurred in four cases (13%; 7.0/1000 PICC days), and catheter-related blood stream infection and thrombosis were reported in one case, each (3%; 1.8/1000 PICC days). Complication cases totaled eight (26%; 14.1/1000 PICC days). The time to complication development ranged from two to 14 days and the median was seven days. There was no PICC complication-related death. Conclusion: Considering characteristics of terminally ill cancer patients, such as a poor general condition, vulnerability to trivial damage, and a limited period of survival, PICC could be a safe intravenous procedure.